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Class Propionic acid derivative NSAID Mechanism of Action Reversibly inhibits COX-1 and COX-2 Prostaglandin synthesis pain, inflammation, fever Indications Mild to moderate pain (headache, dental pain) Dysmenorrhea Musculoskeletal pain Fever Osteoarthritis & rheumatoid arthritis Acute inflammatory conditions Dosage Adults 200400 mg every 68 hours Maximum: OTC: 1,200 mg/day Prescription: 3,200 mg/day Children 10 mg/kg per dose every 68 hours (max 40 mg/kg/day) Adverse Effects Gastrointestinal Gastritis Peptic ulcer disease GI bleeding Renal Acute kidney injury Sodium & water retention Cardiovascular Blood pressure Thrombotic risk (less than COX-2 selective NSAIDs) Others Hypersensitivity reactions Bronchospasm (aspirin-sensitive asthma) Contraindications Active peptic ulcer disease Severe renal impairment NSAID hypersensitivity 3rd trimester of pregnancy Uncontrolled heart failure Drug Interactions Anticoagulants bleeding risk ACE inhibitors / diuretics renal function Other NSAIDs toxicity Take with food to reduce GI irritation Avoid chronic use in elderly Safer than aspirin for GI bleeding, but not risk-free Avoid dehydration while using Ibuprofen = reversible COX inhibitor with good anti-inflammatory effect To view or add a comment, sign in PROTON PUMP INHIBITORS (PPIs) Definition: PPIs are drugs that irreversibly inhibit the H/K ATPase (proton pump) in gastric parietal cells, leading to suppression of gastric acid secretion

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In a randomized controlled trial in 72 subjects with migraine, 50,000 IU (1,250 mcg) of oral vitamin D every two weeks plus a daily multi-strain probiotic providing 450 billion colony forming units (CFUs) for 12 weeks reduced the frequency and severity of migraines (Tirani 2024)